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中华医学超声杂志(电子版) ›› 2017, Vol. 14 ›› Issue (03) : 206 -209. doi: 10.3877/cma.j.issn.1672-6448.2017.03.009

所属专题: 文献

妇产科超声影像学

胎儿肾盂分离超声测值与预测转归的价值
董智芬1, 陈晓芳1, 盛余敬1, 张迎春1,()   
  1. 1. 215004 苏州大学附属第二医院超声中心
  • 收稿日期:2016-10-12 出版日期:2017-03-01
  • 通信作者: 张迎春

The values of anteroposterior diameter in fetal renal pelvis separation and its value of predicting the prognosis

Zhifen Dong1, Xiaofang Chen1, Yujing Sheng1, Yingchun Zhang1,()   

  1. 1. Department of Ultrasound, the Second Affiliated Hospital of Soochow University, Suzhou 215004, China
  • Received:2016-10-12 Published:2017-03-01
  • Corresponding author: Yingchun Zhang
  • About author:
    Corresponding author: Zhang Yingchun, Email:
引用本文:

董智芬, 陈晓芳, 盛余敬, 张迎春. 胎儿肾盂分离超声测值与预测转归的价值[J/OL]. 中华医学超声杂志(电子版), 2017, 14(03): 206-209.

Zhifen Dong, Xiaofang Chen, Yujing Sheng, Yingchun Zhang. The values of anteroposterior diameter in fetal renal pelvis separation and its value of predicting the prognosis[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2017, 14(03): 206-209.

目的

分析不同孕周胎儿肾盂分离(APD)的超声测值及临床预后。

方法

对2013年1月至2015年10月在苏州大学附属第二医院产前超声检查诊断为肾盂分离的182例胎儿均随访至产后12个月,分析最终发展为不可复性肾积水胎儿首次检出孕周及肾盂APD值。

结果

182例胎儿中孕期首次检出肾盂分离46例,晚孕期首次检出肾盂分离136例(双侧肾盂分离92例)。随访过程中,114例肾盂分离在胎儿期自行恢复,52例在出生后12个月内恢复,仅16例(8.8%,16/182)发展为不可复性肾积水。16例不可复性肾积水胎儿中10例(62.5%,10/16)于中孕期检出肾盂分离,肾盂APD测值7.4~11.5 mm,平均(9.6±1.5)mm;6例(37.5%,6/16)于晚孕期检出肾盂分离,肾盂APD测值13.6~14.8 mm,平均(12.8±2.0)mm。结果显示,中孕期检出肾盂分离胎儿的肾盂APD测值小于晚孕期检出肾盂分离的胎儿,且中孕期检出肾盂分离的胎儿预后较差,其发展为不可复性肾积水的胎儿(21.7%,10/46)多于晚孕期检出者(4.4%,6/136)。

结论

产前超声动态观察胎儿肾盂径线,并结合首次检出肾盂分离的孕周及肾盂APD测值,有助于预测胎儿预后。

Objective

To analyze the values of anteroposterior diameter (APD) in fetal renal pelvis separation during different gestational weeks and in predicting the prognosis.

Methods

Totally 182 cases of fetal renal pelvis separation in the Second Affiliated Hospital of Soochow University were enrolled in this study between January 2013 and October 2015. All of them were followed up to 12 months after birth. The detecting gestational weeks of non-reversible renal hydronephrosis and values of fetal renal pelvis APD were analyzed.

Results

Among the 182 cases of fetal renal separation, 46 cases were detected in the second trimester, 136 cases were detected in the third trimester (bilateral renal pelvis separation occurred in 92 cases). During the follow-up, 114 cases recovered in the fetal period and 52 cases recovered within 12 months after birth, finally, 16 cases (8.8%, 16/182) of them progressed to non-reversible renal hydronephrosis. Among the 16 fetus of non-reversible renal hydronephrosis, 10 cases (62.5%, 10/16) were detected in the second trimester, their values of APD were 7.4-11.5 mm and the average was (8.0±1.5) mm; 6 cases (37.5%, 6/16) were detected in the third trimester, their values of APD were 13.6-14.8 mm and the average was (12.8±2.0) mm. The values of APD in fetus who were detected in the second trimester were smaller than those in the fetus who detected in the third trimester and the prognosis in the fetus who were detected in the second trimester was worse than those in the fetus who were detected in the third trimester, the fetus (21.7%, 10/46) who progressed to non-reversible renal hydronephrosis in the second trimester were more than the fetus (4.4%, 6/136) who were detected in the third trimester.

Conclusion

Clinical following-up combined with the detecting gestational weeks of fetal renal pelvis separation and values of fetal renal plevis APD by prenatal ultrasound may be helpful in predicting their prognosis.

图1 孕37+3周胎儿,双肾横切面声像图显示双肾肾盂分离(左肾肾盂分离处于正常范围内,右肾积水),左肾肾盂APD测值为6.0 mm,右肾肾盂APD测值为7.0 mm
图2 肾盂分离胎儿出生后12个月超声随访,肾脏横切面显示左肾积水,肾盂APD测值为11.0 mm
表1 16例肾盂分离发展为不可复性肾积水胎儿产前超声测量结果
表2 肾积水出现时间的APD界值判定
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